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American Red Cross Blood Services "Making A Difference" Educational Scholarship Distribution Form

Instructions: This form must be completed and submitted by an authorized representative of the participating high school. All data fields must be completed. Forms must be submitted to the American Red Cross immediately after the last blood drive of the year. (Current year runs from Labor Day to Labor Day.)

Will the scholarship monies be divided among more than one student?

Institution of Higher Education Attending

Date Student Will Begin Classes

Blood Drive Sponsor Code

Name of Student's Current School

Number To Reach Student's Current School

Name of Authorized School Official Submitting Form

Authorized School Official's Email Address